2011 / 2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Plan Name | Monthly Premium |
Part A&B Maximum Out-Of |
Part D Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Formulary Drugs | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
-- This plan not offered in 2011 -- |
H0294 -002 -0 | |||||||||||
new | new | new | ||||||||||
2012 Care Improvement Plus Gold Rx (PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
2011 Humana Gold Choice H8145-121 (PFFS) | $39.00 | $5,000 | No Rx Coverage | H8145 -121 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-121 (PFFS) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
2012 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
2011 Today's Options Premier 800 (PFFS) | $25.00 | $6,700 | No Rx Coverage | H5421 -047 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Today's Options Premier 400 (PFFS) | $25.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice H5216-006 (PPO) | $31.00 | $4,500 | $0 | Few Generics, Few Brands |
H5216 -006 -0 | $6.00 | $34.00 | $75.00 | $75.00 | n/a | ||
2012 HumanaChoice H5216-006 (PPO) | $31.00 | $4,500 | $0 | Few Generics, Few Brands | $6.00 | $34.00 | $75.00 | $75.00 | 3,798 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H0294 -005 -0 | |||||||||||
new | new | new | ||||||||||
2012 Care Improvement Plus Medicare Advantage Only (PPO) | $35.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
-- This plan not offered in 2011 -- |
H0294 -001 -0 | |||||||||||
new | new | new | ||||||||||
2012 Care Improvement Plus Silver Rx (PPO SNP) | $36.70 | n/a | $205 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H0294 -004 -0 | |||||||||||
new | new | new | ||||||||||
2012 Care Improvement Plus Medicare Advantage (PPO) | $53.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $43.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H5421 -207 -0 | |||||||||||
2012 Today's Options Premier 200 (PFFS) | $60.00 | $3,250 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
2011 Today's Options Premier 850B powered by CCRx (PFFS) | $60.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H5421 -065 -0 | $4.00 | $35.00 | $65.00 | $65.00 | n/a | ||
2012 Today's Options Premier Plus 450B (PFFS) | $60.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 Humana Gold Choice H8145-006 (PFFS) | $61.00 | $6,000 | $0 | Few Generics, Few Brands |
H8145 -006 -0 | $7.00 | $41.00 | $80.00 | $80.00 | n/a | ||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-006 (PFFS) | $61.00 | $6,000 | $0 | Few Generics, Few Brands | $7.00 | $41.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
2011 HumanaChoice R5826-009 (Regional PPO) | $61.00 | $5,000 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | n/a | ||||||
-- | ||||||||||||
2012 HumanaChoice R5826-009 (Regional PPO) | $67.00 | $5,000 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | |||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
-- This plan not offered in 2011 -- |
H5421 -213 -0 | |||||||||||
2012 Today's Options Premier Plus 250A (PFFS) | $119.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 SmartValue Classic (PFFS) | $24.00 | $5,000 | No Rx Coverage | H0540 -090 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 SmartValue Plus (PFFS) | $47.00 | $5,000 | $0 | Many Generics | H0540 -091 -0 | $8.00 | $44.00 | $85.00 | $85.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
2011 HumanaChoice R5826-009 (Regional PPO) | $61.00 | $5,000 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
|